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Biomedical subjects

J P Calvert

Publications and source records attributed to J P Calvert.

16 recordsLinked to original sources
PubMed2001

Lessons from Holland: hospital visiting as an instrument to assess the quality of obstetric and gynecological care.

OBJECTIVE: to assess and improve the quality of hospital based obstetric and gynecological care. STUDY DESIGN: in 1991 a hospital visiting scheme by peers was launched by the Dutch Society of Obstetrics and Gynecology. The present study gives a full description of the scheme and its potential impact on the quality of obstetric and gynecological care in all of the group practices in non-teaching hospitals in the Netherlands (n=87). Comprehensive and multifaceted assessment was done in a standardised way, thereby focusing on the process of care rather than health care outcome. Following each visitation by an ad hoc visiting committee, consisting of three experienced gynecologists, the plenary visitation committee issues a formal report to the participating obstetric and gynecological centre. Apart from the condensed summary of the findings of the visiting committee during the 1 day visit, the report contains recommendations for the improvement of obstetric and gynecological care. RESULTS: problems most commonly encountered during visits were in the areas of communication. Other problem areas frequently encountered include deficient medical record keep and lack of adherence to the standards for postgraduate education. CONCLUSIONS: given the willingness of gynecologists to participate in a constructive way and their readiness to comply with the recommendations, it is concluded that formal visiting could provide an important means of improving obstetric and gynecological care in a hospital setting.

Female↗
PubMed1998

Vaginal vault suspension for prolapse after hysterectomy using an autologous fascial sling of rectus sheath.

OBJECTIVE: To evaluate the results of a modified rectus sheath fascial sling used as a treatment for vaginal vault prolapse after hysterectomy. DESIGN: Retrospective analysis of case records. SETTING: District General Hospital in South Wales. PARTICIPANTS: Ten women who had had a hysterectomy 2 to 20 years previously (mean 8 years). RESULTS: All the women were cured of symptoms related to vaginal vault prolapse. There were no intraoperative complications. No new urinary symptoms have developed. One woman developed an enterocele which was corrected by the abdominal insertion of a prolene mesh. CONCLUSION: A modified rectus sheath fascial sling is a safe, simple effective abdominal operation for the surgical correction of vaginal vault prolapse after hysterectomy.

Aged↗
PubMed1997

Anaerobic (bacterial) vaginosis and premalignant disease of the cervix.

Nitrosamines are carcinogenic substances found in cigarette smoke, and it is known that female smokers have an increased risk of cervical carcinoma and premalignant change. Nitrosamines may also be formed due to the combination of amines and nitrites in an acidic medium. This study has shown a statistically significant association between anaerobic vaginosis which produce amines and cervical intraepithelial neoplasia 2 and 3. In addition nitrate reducing organisms are found in the acidic lower genital tract in a significant number of cases. It is therefore theoretically possible that nitrosamines may be an important agent in the development of premalignant disease of the cervix.

Journal Article↗
PubMed1994

Analgesia after laparoscopic sterilisation. Effect of 2% lignocaine gel applied to Filshie clips.

We performed a randomised controlled study in patients undergoing day case laparoscopic sterilisation to assess whether coating Filshie clips with 2% lignocaine gel prior to application to the Fallopian tubes would reduce postoperative pain. Sixty-two patients were studied, in 33 of whom the Filshie clips were coated in sterile 2% lignocaine gel. Pain scores in the lignocaine gel group were significantly lower than in the control group at 1 h after return to the ward, but no differences were found immediately on return to the ward, or at discharge or at 24 h. There were no significant differences between the two groups in postoperative analgesic requirements or in side effects.

Administration, Topical↗
PubMed1983

Histopathological diagnosis of hydatidiform mole.

Two microscopical methods are described which are useful for the identification of hydatidiform molar trophoblast. The first is an application of Nomarski's differential interference contrast microscopy which allows whole-mounted villi to be studied by optical sectioning. The second is an application of indirect immunofluorescence microscopy using a specific antiserum directed against the endothelial cell structural protein-known as vimentin.

Female↗
PubMed1982

Antenatal screening by measurement of symphysis-fundus height.

A study was undertaken to assess the value of symphysis-fundus measurement as a screening procedure for intrauterine growth retardation. The reproducibility of this measurement was investigated in two groups of six patients, each measured six times by six different observers. The intraobserver coefficient of variation was 4.6% and the interobserver coefficient of variation 6.4%. There was no evidence that experience aided consistency. A chart of symphysis-fundus measurements derived from Cardiff data was found to be similar to others previously published, and one measurement below the 10th centile identified 64% of pregnancies in which the eventual birth weight was below the 10th centile for gestational age. Symphysis-fundus measurement is a useful screening test; one chart could be used for any Caucasian population and should be incorporated into the maternity services "co-operation card."

Birth Weight↗
PubMed1982

An assessment of radiotelemetry in the monitoring of labour.

Conventional and telemetric monitoring of labour were compared in a randomized study of 200 patients to assess the effect on the pattern of labour, outcome and attitude of the patients. All the telemetry patients had the option of mobility, but only 45% elected to get out of bed, and then often only for short periods. No clear physical benefits accrued from voluntary mobility. Ambulant patients who had spontaneous deliveries had a longer second stage and more of their babies were slow to establish regular respiration. Quantitative subjective assessments of pain, anxiety and comfort were made. Primigravidae with telemetric monitoring who chose to get out of bed had higher pain scores than primigravidae monitored conventionally, but anxiety scores were highest among primigravidae with telemetry who elected to stay in bed. There was a significant bias towards increased anxiety in the lower social classes. Primigravidae gained more reassurance from monitoring than did multigravidae, but there were no differences resulting from whether or not the recording apparatus was within the patients' view. Multigravidae who had experienced both forms of monitoring preferred telemetry because they felt less restricted and less anxious.

Anxiety↗
PubMed1979

Fetal breathing movements and fetal distress.

Twenty-seven pregnancies were monitored by antenatal cardiotocographs, daily fetal movement counts and an assessment of fetal breathing activity by real time scanning, and the results of these tests were related to the development of fetal distress during the first stage of labour. The proportion of time during which fetal breathing movements were present, determined over only a short period of time, was found to be a useful predictor of fetal behaviour during a labour.

Female↗
PubMedDate not supplied

Reversal of female sterilisation.

Careful counselling before female sterilisation can reduce reversal requests but will never eliminate them. Approximately performed reversal has a high success rate but there is still a need for better means of reliable but reversible long-term contraception.

Anastomosis, Surgical↗